Xiao Xin-Yun, Zeng Jing-Yi, Cao Yun-Bin, Tang Ying, Zou Zhang-Yu, Li Jian-Qi, Chen Hua-Jun
Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.
Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China.
Quant Imaging Med Surg. 2024 Aug 1;14(8):5774-5788. doi: 10.21037/qims-24-236. Epub 2024 Jul 16.
Amyotrophic lateral sclerosis (ALS)-related white-matter microstructural abnormalities have received considerable attention; however, gray-matter structural abnormalities have not been fully elucidated. This study aimed to evaluate cortical microstructural abnormalities in ALS and determine their association with disease severity.
This study included 34 patients with ALS and 30 healthy controls. Diffusion-weighted data were used to estimate neurite orientation dispersion and density imaging (NODDI) parameters, including neurite density index (NDI) and orientation dispersion index (ODI). We performed gray matter-based spatial statistics (GBSS) in a voxel-wise manner to determine the cortical microstructure difference. We used the revised ALS Functional Rating Scale (ALSFRS-R) to assess disease severity and conducted a correlation analysis between NODDI parameters and ALSFRS-R.
In patients with ALS, the NDI reduction involved several cortical regions [primarily the precentral gyrus, postcentral gyrus, temporal cortex, prefrontal cortex, occipital cortex, and posterior parietal cortex; family-wise error (FWE)-corrected P<0.05]. ODI decreased in relatively few cortical regions (including the precentral gyrus, postcentral gyrus, prefrontal cortex, and inferior parietal lobule; FWE-corrected P<0.05). The NDI value in the left precentral and postcentral gyrus was positively correlated with the ALS disease severity (FWE-corrected P<0.05).
The decreases in NDI and ODI involved both motor-related and extra-motor regions and indicated the presence of gray-matter microstructural impairment in ALS. NODDI parameters are potential imaging biomarkers for evaluating disease severity . Our results showed that GBSS is a feasible method for identifying abnormalities in the cortical microstructure of patients with ALS.
肌萎缩侧索硬化症（ALS）相关的白质微观结构异常已受到广泛关注；然而，灰质结构异常尚未得到充分阐明。本研究旨在评估ALS患者的皮质微观结构异常，并确定其与疾病严重程度的关联。
本研究纳入了34例ALS患者和30名健康对照者。使用扩散加权数据来估计神经突方向离散度和密度成像（NODDI）参数，包括神经突密度指数（NDI）和方向离散度指数（ODI）。我们以体素为基础进行基于灰质的空间统计（GBSS），以确定皮质微观结构差异。我们使用修订的ALS功能评定量表（ALSFRS-R）来评估疾病严重程度，并对NODDI参数与ALSFRS-R进行相关性分析。
在ALS患者中，NDI降低涉及多个皮质区域[主要是中央前回、中央后回、颞叶皮质、前额叶皮质、枕叶皮质和顶叶后皮质；家族性错误率（FWE）校正P<0.05]。ODI在相对较少的皮质区域降低（包括中央前回、中央后回、前额叶皮质和顶下小叶；FWE校正P<0.05）。左侧中央前回和中央后回的NDI值与ALS疾病严重程度呈正相关（FWE校正P<0.05）。
NDI和ODI的降低涉及运动相关和运动外区域，表明ALS患者存在灰质微观结构损伤。NODDI参数是评估疾病严重程度的潜在影像生物标志物。我们的结果表明，GBSS是识别ALS患者皮质微观结构异常的一种可行方法。
